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Table 4 Learning points

From: Imaging of skull vault tumors in adults

Pseudolesions: Very common. Know-them to recognize them
Meningioma and hemangioma can simulate aggressive periosteal reaction
Meningioma: Calcification, dural tail, intense enhancement, hyperostosis. Beware of variable bone involvement. 1H-MRS: Alanine (specific)
Hemangioma: Expansile, trabeculated, spoke-wheel pattern, fatty content.
Epidermal inclusion cyst: Previous injury, DWI restriction
Dermoid cyst: DWI restriction, fatty content
Fibrous dysplasia: Young patient. “Ground-glass” matrix virtually pathognomonic. Possible predominant lytic-cystic component in calvarium
Eosinophilic granuloma: Young patient with focal lytic lesion with “button sequestrum”
Giant-cell tumor: Hypervascular bone expansion lesion with flow-voids
Aneurysmal bone-cyst: Bone-expanding lesion with fluid hemosiderin levels. May be secondary if prominent solid components
Myeloma/metastastasis: Elderly patients with multiple lesions
Blastic metastasis: Prostate, breast, transitional cell, neuroendocrine, PNET, lymphoma
Hypervascular metastasis: thyroid, renal, hepatocarcinoma, neuroendocrine and melanoma
Transdiploic or aggressive single lesion: Differential of plasmacytoma, metastasis, lymphoma or meningeal lesion (meningioma/ SFT). Functional imaging can be useful in narrowing differential